CITY OF LONG BEACH EMPLOYMENT OPPORTUNITY Library Clerk I (Non-Career)

Size: px
Start display at page:

Download "CITY OF LONG BEACH EMPLOYMENT OPPORTUNITY Library Clerk I (Non-Career)"

Transcription

1 CITY OF LONG BEACH EMPLOYMENT OPPORTUNITY Library Clerk I (Non-Career) $ $ per hour DEPARTMENT OF LIBRARY SERVICES POSITION: Under general supervision, performs a wide variety of clerical duties and interfaces with library patrons in providing public and technical library services. EXAMPLES OF DUTIES: forms circulation and service desk duties using the automated system to check out and check in library materials and registers new borrowers; Receives, refunds, and reconciles cash; Interprets and resolves questions regarding library circulation policies and procedures; Uses automated system to receive, transmit, and adjust information; Prepares books and library materials for circulation; Repairs and labels books and materials; Maintains statistical and other records; Types letters, reports, and forms; Operates office machines; and forms other duties as required. MINIMUM QUALIFICATIONS: Must be able to work weekends and evenings. DESIRABLE QUALIFICATIONS: Bilingual ability in English/Spanish or English/Khmer. APPLICATION PROCESS: Interested candidates should submit an application and letter of interest to any Long Beach Public Library by 4:30 p.m. on Friday, August 21, The most qualified candidates will be invited to participate in further selection procedures. Applications are available at all Long Beach Public Libraries or online at The most qualified candidates will be invited to participate in further selection procedures. Incomplete applications or those that do not meet the minimum qualifications will not be considered. The City of Long Beach is an Equal Opportunity Employer. We value and encourage diversity in our workforce. The City of Long Beach intends to provide reasonable accommodations in accordance with the Americans with Disabilities Act of If a special accommodation is desired, or if you would like to request this information in an alternative format, please call (562) In support of the City s Language Access Policy, bilingual skills (Spanish, Khmer and/or Tagalog) are desirable for some positions interacting with the public.

2 LONG BEACH PUBLIC LIBRARY 101 Pacific Avenue Long Beach, CA (562) NON-CAREER APPLICATION FOR EMPLOYMENT Fill out this application completely and accurately by reading and responding to all items. An incorrect or untrue statement may disqualify or remove you from employment. 1. Print title of job you are applying for: 2. Last Name First Name Initial Social Security No. 3. Address City State Zip Code 4. Phone No. 5. address. 6. Have you ever worked for the City of Long Beach? If yes, position and title: 7. Department 8. Date 9. Name if Different 10. Driver s License No., Class, State & Exp. Date 10.a How did you hear about the Job? Social Media Library Website City Website Other: 11. Education: (Check most appropriate box) Student (High School, College) Graduated (High School, College) 12. College or University Attended Major/Minor Type of Degree Earned 13. Certificate of professional or vocational competence, licenses, membership in professional associations: 14. List any languages besides English you can speak and understand 15. The Immigration Reform and Control Act of 1986 requires all new employees to submit verification of identity and authorization to work in the United States at time of hire. Minimum age limit is 18 (16 with either a work permit or a high school diploma or equivalent). Each applicant selected for employment will be medically examined and fingerprinted at City expense. If you have a disability which may require special testing arrangements, you must contact Library Administration at (562) prior to your scheduled examination. AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER

3 16. EXPERIENCE: Begin with your most recent job. List separately each position held even with the same employer. Include volunteer work. Resumes WILL NOT be accepted in place of a completed application. Yrs. Mo. Did you supervise? If yes, how many? Yrs. Mo. Did you supervise? If yes, how many? Yrs. Mo. Did you supervise? If yes, how many? Yrs. Mo. Did you supervise? If yes, how many? Certificate of applicant: I certify that all statements on this application are true and complete. I understand that any false or incomplete information may subject me to disqualification from employment with the City of Long Beach. Signature Date

4 SPECIAL SKILLS AND SUBJECT SPECIALIZATION: Typing WPM: Others (list): Languages Spoken: Read: REFERENCES: Give names of three responsible persons, NOT relatives or friends, who know you. We prefer former employers, supervisors, or teachers. Name Address City Zip Code Phone # Occupation Will you accept: Are you available to work: Temporary Part Time Evenings Saturdays? Sundays? Do you possess a valid driver s license? Number: Please sign your name as you wish it to appear on all records: I FIRST LEARNED OF THIS JOB OPENING THROUGH: (Check only one) A friend or relative The City of Long Beach Civil Service Department A Neighborhood Facility Center bulletin board (please specify Center) sonal contact with a library employee An organization or group (please specify) An advertisement in a newspaper or magazine (please specify) Other means: (please specify)

5 CITY OF LONG BEACH JOB APPLICANTS In compliance with the Immigration Reform and Control Act of 1986,the City of Long Beach requires ALL newly hired employees to show proof of their legal right to work in the United States. At the time of hire, new employees must present original documentation (photocopies are not accepted) to establish both work authorization and identify. Documentation must be either: A. A single document which establishes both employment authorization to work and the identity of the individual. Examples are: U. S. passport Certificate of U. S. citizenship Unexpired foreign passport with work authorization stamp Alien registration card OR A. One document evidencing authorization to work. Examples are: Social Security card (other than one that specifies that employment is unauthorized) U. S. birth certificate (original or certified copy) Unexpired re-entry permit Unexpired Refugee Travel document Certificate of Birth issued by State Department AND B. One document establishing identity. Examples are: Driver s license with photograph Other state-issued identification document found acceptable to the Attorney General. New employees must also complete and sign an Employment Eligibility Verification form (I-9) attesting to their legal right to work and the genuineness of the documents presented. All job offers made by the City are contingent upon establishing proof of an individual s right to work in the United States. AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER 11/04

6 VOLUNTARY SELF-IDENTIFICATION CITY OF LONG BEACH HUMAN RESOURCES AND AFFIRMATIVE ACTION DEPARTMENT The information requested is voluntary and will only be used to determine compliance with federal law. It will not affect consideration of your resume, which will be separated from this form and processed separately. Your voluntary cooperation will be appreciated. NAME: DATE (Please print) POSITION APPLIED FOR: DEPARTMENT: (Please print) (Please print) AGE: [ ] 40 or older [ ] Other HANDICAP: [ ] Yes [ ] No If yes, explain SEX: [ ] Female [ ] Male ETHNIC CATEGORY: [ ] White [ ] Black [ ] Hispanic [ ] Asian or [ ] American Indian or Pacific Islander Alaskan Native WHITE : Includes all non-hispanic or non-black persons having origins in any of the original peoples of Europe, North Africa, or the Middle East. BLACK : includes all non-hispanic persons having origins in any of the Black racial groups of Africa. HISPANIC : includes all persons of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin regardless of race. ASIAN OR PACIFIC ISLANDERS : includes all persons having origins in any of the original peoples of the Far East, Southeast Asian, the Pacific Islands, or the Indian subcontinent. This area includes China, Japan, Korea, Samoa, and the Philippine Islands. AMERICAN INDICAN OR ALASKAN NATIVE : includes all persons having origins in any of the original peoples of North America and who maintain cultural identification through tribal affiliation or community recognition.

EMPLOYMENT APPLICATION

EMPLOYMENT APPLICATION CITY OF JONESBORO 124 North Avenue Jonesboro, Georgia 30236 www.jonesboroga.com EMPLOYMENT APPLICATION THE CITY OF JONESBORO ONLY ACCEPTS APPLICATIONS FOR CURRENTLY POSTED POSITIONS. UNSOLICITED APPLICATIONS

More information

PERSONAL INFORMATION LAST NAME FIRST NAME MIDDLE INITIAL PRIMARY TELEPHONE NUMBER. Are you willing to work: ** For Positions that Require Driving **

PERSONAL INFORMATION LAST NAME FIRST NAME MIDDLE INITIAL PRIMARY TELEPHONE NUMBER. Are you willing to work: ** For Positions that Require Driving ** APPLICATION FOR EMPLOYMENT Personnel Department 7100 S. Garfield Boulevard Bell Gardens, CA 90201 (562) 806-7700 Main line An Equal Opportunity/Affirmative Action Employer Date and Time Stamp (Human Resources

More information

POSITION APPLIED FOR:

POSITION APPLIED FOR: APPLICATION FOR EMPLOYMENT Human Resources Department 9770 Culver Boulevard Culver City, CA 90232-0507 (310) 253-5640 Main line (310) 253-5651 Job line TDD (310) 253-5647 (Hearing Impaired Only) An Equal

More information

City of Newark Newark Boulevard, 4th Floor Newark, CA

City of Newark Newark Boulevard, 4th Floor Newark, CA City of Newark 37101 Newark Boulevard, 4th Floor Newark, CA 94560-3796 EMPLOYMENT APPLICATION Date Received: Accepted Rejected Rejection for: Late Application Incomplete Application Experience Education

More information

City of Newark Newark Boulevard, 4th Floor Newark, CA

City of Newark Newark Boulevard, 4th Floor Newark, CA City of Newark 37101 Newark Boulevard, 4th Floor Newark, CA 94560-3796 EMPLOYMENT APPLICATION Date Received: Accepted Rejected Rejection for: Late Application Incomplete Application Experience Education

More information

POSITION APPLIED FOR:

POSITION APPLIED FOR: APPLICATION FOR EMPLOYMENT Human Resources Department 9770 Culver Boulevard Culver City, CA 90232-0507 (310) 253-5640 Main line (310) 253-5651 Job line TDD (310) 253-5647 (Hearing Impaired Only) An Equal

More information

Last Name First Name Middle Name Social Security Number. Street Address City State and Zip Code. Yes No If not, state Date of Birth

Last Name First Name Middle Name Social Security Number. Street Address City State and Zip Code. Yes No If not, state Date of Birth Application for Employment Date Received: Orono Police Department Attn: Deputy Chief Chris Fischer Received By: 2730 Kelley Parkway Orono, MN 55356 952.249.4700 Please attach resume and letter of intent.

More information

CITY OF GOLETA, CALIFORNIA EMPLOYMENT APPLICATION 130 Cremona Drive, Suite B, Goleta, CA (805)

CITY OF GOLETA, CALIFORNIA EMPLOYMENT APPLICATION 130 Cremona Drive, Suite B, Goleta, CA (805) CITY OF GOLETA, CALIFORNIA EMPLOYMENT APPLICATION 130 Cremona Drive, Suite B, Goleta, CA 93117 (805) 961-7500 Equal Opportunity Employer We consider applicants for all positions without regard to race,

More information

City of Flagler Beach Human Resources Division

City of Flagler Beach Human Resources Division City of Flagler Beach Human Resources Division 105 South 2nd Street, Post Office Box 70 Flagler Beach, Florida 32136 Phone (386) 517-2000 Fax (386) 517-2008 INSTRUCTIONS: Please print or type all information.

More information

Name Home Phone( ) LAST FIRST MIDDLE Cell Phone( ) Address: Address NO STREET CITY STATE ZIP

Name Home Phone( ) LAST FIRST MIDDLE Cell Phone( )  Address: Address NO STREET CITY STATE ZIP Canadian County Children s Justice Center EMPLOYMENT APPLICATION (rev. 01-11) Canadian County is an equal opportunity employer and will consider all applicants for all positions equally without regard

More information

APPLICATION FOR EMPLOYMENT

APPLICATION FOR EMPLOYMENT APPLICATION FOR EMPLOYMENT We are an equal opportunity employer and do not unlawfully discriminate in employment. No question on this application is used for the purpose of limiting or excluding any applicant

More information

APPLICATION FOR EMPLOYMENT. 155 Village Street. Medway, MA fax

APPLICATION FOR EMPLOYMENT. 155 Village Street. Medway, MA fax APPLICATION FOR EMPLOYMENT TOWN OF MEDWAY 155 Village Street Medway, MA 02053 508 533 3294 fax 508 321 4940 The Town of MEDWAY is an Affirmative Action/Equal Employment Opportunity Employer All information

More information

Application for Employment

Application for Employment (An Equal Opportunity Employer) Application for Employment PERSONAL INFORMATION DATE (PRINT) NAME LAST FIRST MIDDLE CURRENT ADDRESS STREET CITY STATE ZIP PHONE NUMBER CELL NUMBER ARE YOU 18 YEARS OR OLDER

More information

APPLICATION FOR EMPLOYMENT

APPLICATION FOR EMPLOYMENT UNITED MIGRANT OPPORTUNITY SERVICES, INC. 2701 S. Chase Avenue P.O. Box 04129 Milwaukee, WI 53204 (414) 389-6000 APPLICATION FOR EMPLOYMENT Personal Information Position/s: Location: Full Name: Last First

More information

Hardee County Board of County Commissioners Equal Employment Opportunity (EEO) Self-Identification Form (completion of this form is voluntary)

Hardee County Board of County Commissioners Equal Employment Opportunity (EEO) Self-Identification Form (completion of this form is voluntary) Please submit to: Hardee County Board of County Commissioners HR Department 205 Hanchey Road, Wauchula, Florida 33873 Phone: (863) 773-2161 Hardee County Board of County Commissioners Equal Employment

More information

ESPERANZA HEALTH SYSTEMS, LTD. D/B/A LA HACIENDA TREATMENT CENTER ARBITRATION AGREEMENT

ESPERANZA HEALTH SYSTEMS, LTD. D/B/A LA HACIENDA TREATMENT CENTER ARBITRATION AGREEMENT ESPERANZA HEALTH SYSTEMS, LTD. D/B/A LA HACIENDA TREATMENT CENTER ARBITRATION AGREEMENT PLEASE READ AND SIGN THIS PAGE BEFORE COMPLETING THE APPLICATION PACKET Esperanza Health Systems, Ltd. D/B/A/ La

More information

Winnebago County Circuit Clerk's Office Charlotte LeClercq, Deputy Chief (815) West State St. Rockford, IL 61101

Winnebago County Circuit Clerk's Office Charlotte LeClercq, Deputy Chief (815) West State St. Rockford, IL 61101 PERSONAL Last name First name Middle name Current address City State Zip code Email address Known by other names Home phone number Alternate phone number Are you 18 years of age or older? Winnebago County

More information

City of Fond du Lac - Application for Employment

City of Fond du Lac - Application for Employment City of Fond du Lac - Application for Employment AN EQUAL OPPORTUNITY EMPLOYER APPLICATION FOR EMPLOYMENT This information is for official use only and will not be released to unauthorized persons nor

More information

Northwest Georgia Housing Authority Application for Employment

Northwest Georgia Housing Authority Application for Employment Northwest Georgia Housing Authority Application for Employment An Equal Opportunity Employer Position Applying For: PERSONAL Name Phone: / (Last) (First) (Middle) Present Address Permanent Mailing SS#

More information

CENTRAL STATE UNIVERSITY An Affirmative Action and an Equal Opportunity Employer

CENTRAL STATE UNIVERSITY An Affirmative Action and an Equal Opportunity Employer Date: CENTRAL STATE UNIVERSITY An Affirmative Action and an Equal Opportunity Employer Application for Employment Return Application To: Central State University Human Resources P.O. Box 1004 Wilberforce,

More information

Employment Application

Employment Application Employment Application APPLICANT INFORMATION Last Name First M.I. Date Street Apartment/Unit # City State ZIP E-mail Date Available Social Security No. Desired Salary Position Applied for Are you a citizen

More information

If you are under 18 years of age, can you provide required proof of Yes No your eligibility to work?

If you are under 18 years of age, can you provide required proof of Yes No your eligibility to work? BELKNAP COUNTY 34 County Drive Laconia, NH 03246 (603) 527-5400 Application for Employment We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin,

More information

Employment Application EQUAL OPPORTUNITY EMPLOYER

Employment Application EQUAL OPPORTUNITY EMPLOYER San Gabriel/Pomona Regional Center 75 Rancho Camino Drive Pomona, CA 91766 (909) 620-7722 Application EQUAL OPPORTUNITY EMPLOYER READ INSTRUCTIONS CAREFULLY BEFORE COMPLETING THIS APPLICATION PRINT Legibly

More information

SOCIAL SECURITY NUMBER *last 4 digits*

SOCIAL SECURITY NUMBER *last 4 digits* MSDE OFFICE USE ONLY Approved Disapproved APPLICATION FOR EMPLOYMENT Maryland State Department of Education Staff Recruitment Section 200 West Baltimore Street Baltimore MD 21201 410-333-3045 (TTY) 410-333-8950

More information

CITY OF NEW BEDFORD APPLICATION FOR EMPLOYMENT PERSONNEL DEPARTMENT, NEW BEDFORD, MA (508) An Equal Opportunity Employer

CITY OF NEW BEDFORD APPLICATION FOR EMPLOYMENT PERSONNEL DEPARTMENT, NEW BEDFORD, MA (508) An Equal Opportunity Employer CITY OF NEW BEDFORD APPLICATION FOR EMPLOYMENT PERSONNEL DEPARTMENT, NEW BEDFORD, MA 02740 (508) 979-1444 An Equal Opportunity Employer The City of New Bedford does not discriminate in hiring or employment

More information

APPLICATION FOR EMPLOYMENT

APPLICATION FOR EMPLOYMENT APPLICATION FOR EMPLOYMENT PRINCE WILLIAM-MANASSAS REGIONAL ADULT DETENTION CENTER 9319 Mosby Street, Manassas, Va. 20110 PHONE: 703/792-5824, 703/792-6442 or 703/792-5840 Adult Detention Center Employment

More information

McALESTER PUBLIC SCHOOLS McAlester, Oklahoma APPLICATION FOR SCHOOL SECRETARY & TEACHER ASSISTANT

McALESTER PUBLIC SCHOOLS McAlester, Oklahoma APPLICATION FOR SCHOOL SECRETARY & TEACHER ASSISTANT McALESTER PUBLIC SCHOOLS McAlester, Oklahoma APPLICATION FOR SCHOOL SECRETARY & TEACHER ASSISTANT I am applying for: Secretary Teacher Assistant Date: Social Security Number: Name: Phone: ( ) Home Address:

More information

CITY OF WATERBURY HUMAN RESOURCES DEPARTMENT

CITY OF WATERBURY HUMAN RESOURCES DEPARTMENT HUMAN RESOURCES DEPARTMENT OPEN COMPETITIVE EXAMINATION FOR: POLICE OFFICER Open Competitive Exam # 2150 SALARY: $1,095.00 per week FRINGE BENEFITS: Choose from available health insurance plans (employee

More information

Dayton School District #8 COACHING EMPLOYMENT APPLICATION An Equal Opportunity and Affirmative Action Employer

Dayton School District #8 COACHING EMPLOYMENT APPLICATION An Equal Opportunity and Affirmative Action Employer A District with heart developing minds PERSONAL IDENTIFICATION: Dayton School District #8 COACHING EMPLOYMENT APPLICATION An Equal Opportunity and Affirmative Action Employer Complete each question fully

More information

WALTON COUNTY PROPERTY APPRAISER S OFFICE APPLICATION FOR AT-WILL EMPLOYMENT

WALTON COUNTY PROPERTY APPRAISER S OFFICE APPLICATION FOR AT-WILL EMPLOYMENT WALTON COUNTY PROPERTY APPRAISER S OFFICE APPLICATION FOR AT-WILL EMPLOYMENT P.O. BOX 691, DEFUNIAK SPRINGS, FL 32435 (850) 892-8123 FAX (850) 892-8374 We are proud to be an Equal Employment Opportunity,

More information

EMPLOYMENT APPLICATION CITY OF BILLINGS P.O. BOX 1178 BILLINGS, MT Notice to Applicants PERSONAL INFORMATION

EMPLOYMENT APPLICATION CITY OF BILLINGS P.O. BOX 1178 BILLINGS, MT Notice to Applicants PERSONAL INFORMATION EMPLOYMENT APPLICATION CITY OF BILLINGS P.O. BOX 1178 BILLINGS, MT 59103 Notice to Applicants We welcome you as an applicant for employment. It is the policy of the City of Billings to consider applicants

More information

EMPLOYMENT APPLICATION

EMPLOYMENT APPLICATION EMPLOYMENT APPLICATION Oklahoma Health Care Authority Human Resources Department 4345 N. Lincoln Boulevard Oklahoma City, Oklahoma 73105 PHONE: 405.522.7093 FAX: 405.530.7218 EMAIL: personnel@okhca.org

More information

Application for Employment

Application for Employment Application for Employment Mission Statement The Metro YMCAs of the Oranges strengthens community through youth development, healthy living and social responsibility The YMCA maintains a zero tolerance

More information

We provide services to others in need, with kindness and compassion. We strive for improvements and desire healthy outcomes in our patient care.

We provide services to others in need, with kindness and compassion. We strive for improvements and desire healthy outcomes in our patient care. MISSION STATEMENT Riggs Community Health Center is dedicated to the mission of improving access to quality, cost effective, comprehensive health care with respect and compassion to underserved community

More information

YOUTH AIDE Job Announcement Spring 2018

YOUTH AIDE Job Announcement Spring 2018 CITY OF SACRAMENTO Department of Parks and Recreation Landscape and Learning Youth Employment Program YOUTH AIDE Job Announcement Spring 2018 The Landscape and Learning program is an employment program

More information

Last First Middle. Number Street City State Zip Code. Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Last First Middle. Number Street City State Zip Code. Monday Tuesday Wednesday Thursday Friday Saturday Sunday GOODWILL INDUSTRIES OF NORTHEASTERN PA 925 PROSPECT AVENUE, SCRANTON, PA 18505 Phone: (570) 343-1166 Fax: (570) 343-6765 Residential: (570) 706-9586 Fax: (570) 706-9587 www.goodwillnepa.org Applicants

More information

This application must be completed even if a resume is submitted.

This application must be completed even if a resume is submitted. MISSOULA URBA TRASPORTATIO DISTRICT EMPLOMET APPLICATIO Position applied for: Date of application: This application must be completed even if a resume is submitted. Instructions: 1. Download the application

More information

APPLICATION FOR EMPLOYMENT

APPLICATION FOR EMPLOYMENT PERSONAL INFORMATION (PLEASE PRINT OR TYPE) DATE: NAME: (FIRST, MIDDLE, LAST) SSN: PHONE: ALT. PHONE: E-MAIL ADDRESS: ( ) ( ) REFERRAL SOURCE WALK IN ADVERTISEMENT RELATIVE EMPLOYMENT AGENCY EMPLOYEE OTHER

More information

APPLICATION FOR EMPLOYMENT

APPLICATION FOR EMPLOYMENT 5230 West Highway 98 Panama City, FL 32401-1041 APPLICATION FOR EMPLOYMENT DATE OF APPLICATION: All sections of this application must be completed Incomplete applications will not be considered. Resumes

More information

City of Elk Grove Application for Appointment

City of Elk Grove Application for Appointment City of Elk Grove Application for Appointment Elk Grove Youth Commission INSTRUCTIONS: Provide all information requested; use ink; any attachments must be single sided on 8.5 x 11 paper. If you will be

More information

YOUTH AIDE Job Announcement Summer 2018

YOUTH AIDE Job Announcement Summer 2018 CITY OF SACRAMENTO Department of Youth, Parks, & Community Enrichment Landscape and Learning Youth Employment Program YOUTH AIDE Job Announcement Summer 2018 The Landscape and Learning program is an employment

More information

Application for Employment

Application for Employment Application for Employment It is the policy of BGCGW that all applicants for employment and all employees are recruited, hired, and assigned on the basis of merit without regard to race, color, religion,

More information

WESLACO INDEPENDENT SCHOOL DISTRICT

WESLACO INDEPENDENT SCHOOL DISTRICT WESLACO INDEPENDENT SCHOOL DISTRICT HUMAN RESOURCES DEPARTMENT 319 W. 4th Street PO Box 266 Weslaco, Tx 78599-0266 www.wisd.us Phone (956) 969-6619 Fax (956) 969-6932 SUBSTITUTE APPLICANT ONLY Dr. Priscilla

More information

Application for Employment

Application for Employment Application for Employment Classified Personnel Green Hills Area Education Agency P.O. Box 1109 Council Bluffs, IA 51502-1109 712-366-7762 800-432-5804 (in Iowa) Fax: 712-366-7777 Applicants for all positions

More information

APPLICATION FOR EMPLOYMENT. Please Print. Name Last First Middle. Address. City, State and Zip. Phone Missouri Driver s License No.

APPLICATION FOR EMPLOYMENT. Please Print. Name Last First Middle. Address. City, State and Zip. Phone Missouri Driver s License No. APPLICATION FOR EMPLOYMENT Remit to: Human Resources Dept. CITY OF TROY 800 Cap Au Gris Troy, Missouri 63379 (636) 528-4712 (636) 462-2619 (fax) Please Print Date Name Last First Middle Address _ City,

More information

SUFFOLK REDEVELOPMENT AND HOUSING AUTHORITY 530 East Pinner Street, Suffolk, Virginia Phone: Fax:

SUFFOLK REDEVELOPMENT AND HOUSING AUTHORITY 530 East Pinner Street, Suffolk, Virginia Phone: Fax: Application #: SUFFOLK REDEVELOPMENT AND HOUSING AUTHORITY 530 East Pinner Street, Suffolk, Virginia 23434 AN EQUAL OPPORTUNITY EMPLOYER Phone: 757-539-2100 Fax: 757-539-5184 E-Mail: srha@suffolkrha.org

More information

Pf C Partners for Community

Pf C Partners for Community Pf C Partners for Community EMPLOYMENT APPLICATION Applicants for employment are considered without regard to any basis prohibited by law including race, color, religion, sex, marital status, national

More information

APPLICATION FOR EMPLOYMENT Montgomery County Olen Underwood Juvenile Justice Center Montgomery County, TX

APPLICATION FOR EMPLOYMENT Montgomery County Olen Underwood Juvenile Justice Center Montgomery County, TX 1 APPLICATION FOR EMPLOYMENT Montgomery County Olen Underwood Juvenile Justice Center Montgomery County, TX 200 Academy Drive Conroe, TX 77301 Ph # (936) 538-3485 Fax # (936) 538-3461 An Equal Employment

More information

PLEASE PRINT ALL INFORMATION REQUESTED EXCEPT SIGNATURE ON PAGES 5 & 6. Name LAST FIRST MIDDLE MAIDEN. Present Address NUMBER STREET CITY STATE ZIP

PLEASE PRINT ALL INFORMATION REQUESTED EXCEPT SIGNATURE ON PAGES 5 & 6. Name LAST FIRST MIDDLE MAIDEN. Present Address NUMBER STREET CITY STATE ZIP EMPLOYEE APPLICATION Catholic Charities of the Diocese of Santa Rosa (Catholic Charities) is an Equal Opportunity Employer. Race, color, religion, age, sex, promotion, disability, marital or veteran status,

More information

Municipal Government Internships

Municipal Government Internships Municipal Government Internships The City of Tomball s Municipal Internship program provides students with on the job training and experience while making important contributions to the City. Students

More information

Application for Employment

Application for Employment Application for Employment Main Office/Terminal Location: 6001 Palmer Avenue Eddyville, IA 52553 Phone: 641/969 4534 Fax: 641/969 4338 Terminal Location: 1501 East Main Street Knoxville, IA 50138 Phone:

More information

EMPLOYMENT APPLICATION

EMPLOYMENT APPLICATION EMPLOYMENT APPLICATION POSITION DESIRED: Today s Date: _ Professional License/Certification # (State of California): Other State License/Certification #: Issue Date: Exp. Date: Issue Date: Exp. Date: Has

More information

PRE-EMPLOYMENT 1700 Hillside Blvd. QUESTIONNAIRE Colma, CA AN EQUAL Tel: (650)

PRE-EMPLOYMENT 1700 Hillside Blvd. QUESTIONNAIRE Colma, CA AN EQUAL Tel: (650) LUCKY CHANCES Casino & Fine Dining PRE-EMPLOYMENT 1700 Hillside Blvd. QUESTIONNAIRE Colma, CA 94014 AN EQUAL Tel: (650) 758-2237 OPPORTUNITY EMPLOYER Fax: (650) 758-6462 Email: Jobs@LuckyChances.com APPLICATION

More information

City of Kettering Parks, Recreation and Cultural Arts Department Application Supplement

City of Kettering Parks, Recreation and Cultural Arts Department Application Supplement City of Kettering Parks, Recreation and Cultural Arts Department Application Supplement Have you worked for the City of Kettering in the past? Yes No If yes, when and in what position? Please place a check

More information

The management team at Kensington Village Apartments looks forward to your residency. In order to move in we will require:

The management team at Kensington Village Apartments looks forward to your residency. In order to move in we will require: Dear Prospective Resident, The management team at Kensington Village Apartments looks forward to your residency. In order to move in we will require: 1. A completed application from each applicant 18 years

More information

Employment Application

Employment Application Employment Application It is the policy of Frank Beverage Group to ll every position without regard to race, color, religion, creed, sex, marital status, age, national origin, ancestry, physical or mental

More information

Application for Employment Pre-Employment Questionnaire

Application for Employment Pre-Employment Questionnaire Kemco Industries, Inc. An Equal Opportunity Employer Application for Employment Pre-Employment Questionnaire Kemco Industries, Inc. is an equal opportunity employer and its policy is to fill every position

More information

Transit Connection, Inc. MVBP RR 1, Box 3 Edgartown, MA

Transit Connection, Inc. MVBP RR 1, Box 3 Edgartown, MA Transit Connection, Inc. MVBP RR 1, Box 3 Edgartown, MA 02539 508.693.9440 www.vineyardtransit.com Dear Applicant, Thank you for considering Transit Connection, Inc. (TCI) for employment. As the operations

More information

Florence County Employment Application

Florence County Employment Application Personal Data Florence County Employment Application Name: First: Middle: Last: : Number: Alternate Number: E-mail : Have you been known by another name? (If so, please indicate) If you are under 18 years

More information

Employment Application

Employment Application Employment Application Current job opportunities are posted on our website at www.ariseinc.org/employment. We consider applicants for all positions without regard to race, religion, creed, gender, age,

More information

EMPLOYMENT APPLICATION

EMPLOYMENT APPLICATION EMPLOYMENT APPLICATION Thank you for your interest in a position with the Niagara Frontier Transportation Authority (NFTA), or its wholly owned subsidiary, Niagara Frontier Transit Metro System, Inc. (

More information

APPLICATION FOR EMPLOYMENT

APPLICATION FOR EMPLOYMENT JUDSON PARK A COMMUNITY OF AMERICAN BAPTIST HOMES OF THE WEST 23600 Marine View Drive South Des Moines, WA 98198 206.824.4000 www.retirementlife.com APPLICATION FOR EMPLOYMENT PERSONAL INFORMATION (Please

More information

City of Kettering Parks, Recreation & Cultural Arts Department Temporary/Seasonal Application Supplement

City of Kettering Parks, Recreation & Cultural Arts Department Temporary/Seasonal Application Supplement City of Kettering Parks, Recreation & Cultural Arts Department Temporary/Seasonal Application Supplement Please help us best route your application by answering the following questions. I know what position

More information

VOLUNTEER APPLICATION PACKET

VOLUNTEER APPLICATION PACKET NAME: : (PLEASE PRINT CLEARLY) (Last) (First) (Middle) ADDRESS: CITY: ZIP: SOCIAL SECURITY NUMBER: - - OF BIRTH: HOME PHONE: WORK PHONE: E-MAIL ADDRESS: CONTACT IN CASE OF EMERGENCY: (name) (relationship)

More information

LOUISIANA UNITED METHODIST CHILDREN AND FAMILY SERVICES, INC. P.O. BOX 929 RUSTON, LA

LOUISIANA UNITED METHODIST CHILDREN AND FAMILY SERVICES, INC. P.O. BOX 929 RUSTON, LA LOUISIANA UNITED METHODIST CHILDREN AND FAMILY SERVICES, INC. P.O. BOX 929 RUSTON, LA 71273 WWW.LMCH.ORG EMPLOYMENT APPLICATION Louisiana United Methodist Children and Family Services believes ensuring

More information

Michelle Hayes Assistant Superintendent Personnel Services

Michelle Hayes Assistant Superintendent Personnel Services Michelle Hayes Assistant Superintendent Personnel Services Phone: (619) 588-3049 Fax: (619) 588-3663 E-mail: hayesm@cajonvalley.net Office Address: 750 E. Main Street, El Cajon, CA 92020 Mailing Address:

More information

NAME: LAST NAME FIRST NAME MIDDLE INITIAL

NAME: LAST NAME FIRST NAME MIDDLE INITIAL JOHNSTON PUBLIC SCHOOLS 10 Memorial Avenue Johnston, Rhode Island 02919 Phone: 401-233-1900 / Fax: 401-233-1907 www.johnstonschools.org COACH ASSISTANT COACH VOLUNTEER COACH APPLICAT ION FO R EM PLOYM

More information

High Desert ESD Employment Application 2804 SW Sixth Street Redmond OR Attn: HR Specialist Phone: (541) FAX:

High Desert ESD Employment Application 2804 SW Sixth Street Redmond OR Attn: HR Specialist Phone: (541) FAX: High Desert ESD Employment Application 2804 SW Sixth Street Redmond OR 97756 Attn: HR Specialist Phone: (541) 693-5600 FAX: 541-693-5601 www.hdesd.org Last Name First Name M.I. Date Mailing Address City

More information

Position Applied For: Application Date:

Position Applied For: Application Date: An Equal Opportunity /Drug-Free Work Environment Employment Application (Please Print or Type) All sections must be fully completed in order to qualify for employment consideration. Position Applied For:

More information

MUST BE COMPLETED IN FULL.

MUST BE COMPLETED IN FULL. Complete and Return to: Boards and Commissions 77 South High Street 23 rd Floor Columbus, OH 43215 Phone: (614) 466-5768 The State of Ohio is an equal opportunity employer and will not use any of the information

More information

Preliminary Application for Housing. Please Check One Facility Per Application! DGN I, Inc. DGN II, Inc. DGN III, Inc. Head of Household (HOH):

Preliminary Application for Housing. Please Check One Facility Per Application! DGN I, Inc. DGN II, Inc. DGN III, Inc. Head of Household (HOH): Douglas Gardens Senior Housing, Inc. Management Agent 705 SW 88th Avenue Pembroke Pines, Florida 33025 TTY/VCO 800-955-8771 / Phone 954-704-3464 / Fax 954-438-1050 Preliminary Application for Housing Please

More information

CERTIFIED SUBSTITUTE TEACHING APPLICATION FORM

CERTIFIED SUBSTITUTE TEACHING APPLICATION FORM CERTIFIED SUBSTITUTE TEACHING APPLICATION FORM Date of this application: APPLICATION OF: Montana City School 11 McClellan Creek Road Clancy, Montana 59634 AN EQUAL OPPORTUNITY EMPLOYER THAT ENCOURAGES

More information

CASHMERE SCHOOL DISTRICT 210 S. DIVISION CASHMERE WA

CASHMERE SCHOOL DISTRICT 210 S. DIVISION CASHMERE WA CASHMERE SCHOOL DISTRICT 210 S. DIVISION CASHMERE WA 98815 www.cashmere.wednet.edu CLASSIFIED APPLICATION Please find attached a packet of application materials for a classified position with the Cashmere

More information

2408 Parkland Ave., Artesia NM Employment Application APPLICATION INSTRUCTIONS

2408 Parkland Ave., Artesia NM Employment Application APPLICATION INSTRUCTIONS 2408 Parkland Ave., Artesia NM 88210 Employment Application NAME LAST FIRST M.I. SOCIAL SECURITY NO. APPLICATION INSTRUCTIONS IT IS IMPORTANT THAT YOU READ ALL INSTRUCTIONS CAREFULLY AND FILL OUT THIS

More information

CITY OF SHERIDAN, WYOMING

CITY OF SHERIDAN, WYOMING CITY OF SHERIDAN, WYOMING Office Use Only Received: HUMAN RESOURCES DEPARTMENT Phone: (307) 674-6483 (Please Use for mailing) Fax: (307) 675-4270 55 East Grinnell, P.O. Box 848 Email: hdoke@sheridanwy.net

More information

CITY OF VALPARAISO APPLICATION FOR EMPLOYMENT

CITY OF VALPARAISO APPLICATION FOR EMPLOYMENT CITY OF VALPARAISO APPLICATION FOR EMPLOYMENT If you are an applicant with a disability that you believe would prevent you, in any way from fully participating in the application process, please alert

More information

ELEVENTH JUDICIAL CIRCUIT OF FLORIDA APPLICATION FOR CERTIFICATION OF PRIVATE COURT APPOINTED COUNSEL

ELEVENTH JUDICIAL CIRCUIT OF FLORIDA APPLICATION FOR CERTIFICATION OF PRIVATE COURT APPOINTED COUNSEL ELEVENTH JUDICIAL CIRCUIT OF FLORIDA APPLICATION FOR CERTIFICATION OF PRIVATE COURT APPOINTED COUNSEL Name: Firm Name: Business Address: Business Telephone: Social Security No.: The Florida Bar No.: Zip:

More information

Driver Application (Please Print Clearly)

Driver Application (Please Print Clearly) Full-Time Seasonal Applicant Name: Date: Current Phone # Street City State Zip Are you at least 22 years of age OR older? Y or N Do you have an authorization to work in the U.S.? Y or N Do you have a valid

More information

GREEN LAKE COUNTY EMPLOYMENT APPLICATION

GREEN LAKE COUNTY EMPLOYMENT APPLICATION All applications must be signed and returned to the County Clerk s office by the deadline specified in the job notice. () Applications may be returned by mail or fax. Applications will be accepted electronically

More information

Personnel & Human Resources Office

Personnel & Human Resources Office Personnel & Human Resources Office Dear Applicant: Thank you for your interest in the Mount Vernon School District! It is District policy that we do not accept applications unless you are applying for

More information

Application for Employment

Application for Employment Application for Employment 515 SW Western Blvd. Corvallis, OR 97333 Phone: (541) 757-6426 Fax: (541) 757-2552 www.workunlimited.org Personal Information Name: Date: Primary Phone: Secondary Phone: Position

More information

Borough of Hillsdale

Borough of Hillsdale Borough of Hillsdale 380 Hillsdale Avenue Hillsdale, New Jersey 07642-2794 Fax: 201-358-5002~ www.hillsdalenj.org Employment Application Applicant Information: Name (Last, First, Middle): City/Town: Phone

More information

Return to facility/person you obtained the application.

Return to facility/person you obtained the application. Instructions for manual employment applications Today s Date: Due to the volume of applications received, we will not be able to respond to requests of application status. Please ensure you indicate your

More information

C. Martin Company, Inc. A Woman Owned, Veteran Owned, ISO 9001:2008, and EPA Lead- Safe Certified Firm

C. Martin Company, Inc. A Woman Owned, Veteran Owned, ISO 9001:2008, and EPA Lead- Safe Certified Firm C. Martin Company, Inc. A Woman Owned, Veteran Owned, ISO 9001:2008, and EPA Lead- Safe Certified Firm EMPLOYMENT APPLICATION 3395 West Cheyenne Ave., Suite 102 North Las Vegas, NV 89032 PH (702) 656-8080

More information

Municipality of PENN HILLS

Municipality of PENN HILLS Municipality of PENN HILLS 12245 Frankstown Road Pittsburgh, PA 15235 PHONE: 412.798.2100 FAX: 412.798.2109 APPLICATION FOR EMPLOYMENT POSITION DESIRED: DATE: NAME: / / (Last) (First) (M.I) ADDRESS: (Number

More information

LETTER OF REASONABLE ASSURANCE

LETTER OF REASONABLE ASSURANCE LETTER OF REASONABLE ASSURANCE To: From: Substitute Teachers/Substitute Paraprofessionals James D. Baker, Director of Human Resources This letter provides notice of reasonable assurance of continued employment

More information

Keokuk Police Department

Keokuk Police Department Keokuk Police Department Mission Statement: The Keokuk Police Department is committed to providing Quality Professional Law Enforcement Services to the community. History: The Keokuk Police Department

More information

APPLICATION FOR HOUSING WAIT LIST

APPLICATION FOR HOUSING WAIT LIST PROVIDENCE STAFF USE ONLY Date/Time Received: Staff Initials: APPLICATION FOR HOUSING WAIT LIST We do not have any vacancies at this time. To be placed on our wait list(s), please complete this application,

More information

Keokuk Police Department

Keokuk Police Department Keokuk Police Department Mission Statement: The Keokuk Police Department is committed to providing Quality Professional Law Enforcement Services to the community. History: The Keokuk Police Department

More information

APPLICATION FOR HOUSING WAIT LIST

APPLICATION FOR HOUSING WAIT LIST PROVIDENCE STAFF USE ONLY Date/Time Received: Staff Initials: Vincent House 1423 First Avenue, Seattle WA 98101 Phone: 206-682-9307 Fax: 206-682-0548 TTY: 800-833-6388 WA Relay: 711 APPLICATION FOR HOUSING

More information

STATE COURTS SYSTEM SIXTH JUDICIAL CIRCUIT

STATE COURTS SYSTEM SIXTH JUDICIAL CIRCUIT STATE COURTS SYSTEM SIXTH JUDICIAL CIRCUIT EMPLOYMENT APPLICATION The Sixth Judicial Circuit is an Equal Opportunity Employer. The Court does not discriminate on the basis of race, religion, color, sex,

More information

APPLICATION FOR CERTIFICATED SUBSTITUTE EMPLOYMENT

APPLICATION FOR CERTIFICATED SUBSTITUTE EMPLOYMENT APPLICATION FOR CERTIFICATED SUBSTITUTE EMPLOYMENT Date: 1. Name: Last First Middle Current Address: Home Telephone: ( ) - Cell Phone: ( ) - E-Mail: Social Security No.: - - Former Name(s) by which records

More information

CITY OF MOSCOW POLICE DEPARTMENT LAW ENFORCEMENT APPLICATION FOR EMPLOYMENT

CITY OF MOSCOW POLICE DEPARTMENT LAW ENFORCEMENT APPLICATION FOR EMPLOYMENT CITY OF MOSCOW POLICE DEPARTMENT LAW ENFORCEMENT APPLICATION FOR EMPLOYMENT City of Moscow Human Resources www.ci.moscow.id.us 206 East 3 rd Street (208) 883-7000 phone P. O. Box 9203 (208) 883-7019 TDD

More information

Employment Application

Employment Application Employment Application IMPORTANT Instructions for completing the application form. 1. Type or print clearly in black or blue ink. 2. Answer every question fully and accurately. If not applicable, please

More information

Employment Application City of Fergus Falls ~ 112 West Washington ~ Fergus Falls, MN ~ Phone (218)

Employment Application City of Fergus Falls ~ 112 West Washington ~ Fergus Falls, MN ~ Phone (218) Employment Application City of Fergus Falls ~ 112 West Washington ~ Fergus Falls, MN 56537 ~ Phone (218) 332-5400 1) Title (of specific position you are applying for) 2) Date of Application 3) Date available

More information

MSU Child Development Laboratories Hiring Packet

MSU Child Development Laboratories Hiring Packet MSU Child Development Laboratories Hiring Packet College of Social Science Department of Human Development and Family Studies Child Development Laboratories East Lansing Campus Central School 325 W. Grand

More information

Application for Employment

Application for Employment Application for Employment DRUG TESTING REQUIRED BEFORE HIRE We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or

More information

Absentee Shawnee Tribe

Absentee Shawnee Tribe Absentee Shawnee Tribe 2025 Gordon Cooper Drive Shawnee, OK 74801 405-275-4030 Employment Application We consider applicants for all positions without regard to race, color, religion, sex, national origin,

More information

APPLICATION FOR EMPLOYMENT

APPLICATION FOR EMPLOYMENT Additional infromation Secondary and Postsecondary Education Personal Information Position Information Alabama Community System Application No. APPLICATION FOR EMPLOYMENT Title of position for which you

More information

Remit to: s. Human Resources Dept. CITY OF TROY. 800 Cap Au Gris Troy, Missouri ) ) ( fax) APPLICATION FOR EMPLOYMENT

Remit to: s. Human Resources Dept. CITY OF TROY. 800 Cap Au Gris Troy, Missouri ) ) ( fax) APPLICATION FOR EMPLOYMENT OV TROY/ I I/ TR. Est. 1819 How did you hear about this job? _ newspaper _ City website _ Facebook _ Indeed _ other Remit to: s Human Resources Dept. o CITY OF TROY 800 Cap Au Gris Troy, Missouri 63379

More information